PTSD VA Rating

If you are a veteran suffering from service-related PTSD, you could be entitled to VA disability benefits. When you have a present condition or disability that can be linked through medical evidence to qualifying active duty in the U.S. Armed Forces, you will generally qualify for VA disability benefits. These include not only full coverage for your medical needs and costs but also the potential to receive tax-free monthly compensation. 

Being approved for your VA disability benefits requires that you file an application with evidence to prove your condition and its service connection.  The best way to support this is by working with one of the VA disability lawyers from our VA disability law firm for assistance throughout the process. If you’ve been denied, we can process the appeal, as our team has extensive experience helping veterans with PTSD. 

Symptoms of PTSD

As explained by the National Institute of Health (NIH), post-traumatic stress disorder, or PTSD, is a result of a traumatic experience that the individual suffering from the condition went through. Following a traumatic event, most individuals are able to recover from the resulting symptoms over time. Persons who continue to experience the symptoms of PTSD in the long term following the traumatic event could be diagnosed with PTSD.

Persons who have PTSD may experience stress and fear despite the fact that they are no longer in danger. The symptoms of PTSD generally begin within the first 3 months following a traumatic event but can emerge later in time. Some individuals recover within 6 months, while others experience symptoms that can last for one year or longer. 

To receive a diagnosis of PTSD, an adult must have the following symptoms for a minimum of one month:

• A minimum of one re-experiencing symptom
• One minimum avoidance symptom
• Two minimum arousal and reactivity symptoms
• Two minimum cognition and mood symptoms 

Re-experiencing symptoms include:

• Flashbacks – These are when you relive the traumatic event and experience physical symptoms such as sweating or a fast heartbeat 
• Distressing thoughts 
• Physical manifestations of stress 
• Recurring memories or dreams related to the traumatic event 

Avoidance symptoms include:

• Keeping away from particular places, events, or objects that remind you of the traumatic experience
• Trying to avoid thoughts or feelings that are linked to the traumatic event 

Arousal and reactivity symptoms include:

• Difficulty concentrating 
• Feeling that you are on edge, on guard, or tense
• Experiencing difficulty falling or staying asleep 
• Feelings of irritability and anger or aggressive outbursts
• Engaging in behavior that is risky, destructive, or reckless 

Cognition and mood symptoms include:

• Experiencing difficulty remembering key aspects of the traumatic event
• Thinking negatively about oneself or the outside world 
• Ongoing negative emotions like anger, shame, guilt, or fear
• A loss of interest in activities you engaged in prior to the trauma 
• Experiencing difficulty feeling positive emotions like satisfaction and happiness 

The symptoms of PTSD can substantially impact your ability to live your day-to-day life, with the evidence proving this determining your PTSD VA rating. 

Causes of PTSD

The causes of PTSD, as noted by the NIH, can vary, but generally, it happens to persons who have experienced or witnessed an assault, whether physical or sexual, abuse, an accident, a disaster, a terror attack, or other serious events. Not all PTSD is a result of directly experiencing a traumatic event, but it can also happen when an individual learns that a friend or close relative went through trauma.

As noted by the National Center for PTSD, a program through the U.S. Department of Veterans Affairs (VA), about 6 out of every 100 individuals experience PTSD at some point in their life. Women are generally more likely than men to develop PTSD, and certain biological factors can also influence a person’s development of PTSD. 

How PTSD Can Impact Your Daily Life and Well-Being 

When PTSD is present, your ability to live your life in the same way as before the condition is impacted. Both social and occupational environments may be difficult or impossible to engage in, in turn impacting your quality of life and capacity to earn a living. To meet the criteria for PTSD, generally:

• You must have symptoms for longer than 1 month
• The symptoms must be severe enough to get in the way of elements of your daily life, including relationships or work.
• The symptoms of your PTSD must be unrelated to substance use, other illness, or medication.

Persons with PTSD often have concurrent conditions, those that happen at the same time, including:

• Substance use
• Anxiety disorder/s 
• Depression 

It should be noted that VA will not service connect substance abuse disorder as a free-standing issue, but will connect it if it is the result of, or part of, the service-connected PTSD.

As a result of the symptoms of PTSD, you may feel socially withdrawn or experience greater difficulty engaging in social interactions than before your condition. PTSD impacts your quality of life, and VA disability benefits will provide coverage for mental health services and medications, as necessary, to improve upon your well-being. Receiving an accurate PTSD VA rating is central to this, and your VA disability lawyer from our firm can help. 

The Impact of PTSD on Work 

The many symptoms of PTSD that you might experience can seriously get in the way of a productive work life. PTSD impacts your ability to concentrate and can result in memory problems, both of which are essential aspects of performing on the job. The negative impact that PTSD has on a person’s ability and willingness to engage in social situations also affects relationships with coworkers. 

Persons who have PTSD may also worry that they will experience panic attacks, flashbacks, or other issues while at work. This can lead to social isolation and a fear of being in public. Too many symptoms of PTSD serve to harm a veteran’s ability to earn a steady income, which is why tax-free compensation is available from the VA for qualifying service-connected disabilities and conditions that are rated at 10 percent disability or greater. 

The VA Rating Criteria to Evaluate PTSD

When the VA rates your PTSD claim, it applies its own rating formula derived through the Diagnostic Criteria and also considers the information provided within the DSM-5-TR, the American Psychological Association’s compilation of mental health conditions, to define PTSD. Following your compensation and pension (C&P) exam, and consideration of any additional evidence you provide, the VA will determine whether your PTSD rating is 0 percent, 10 percent, 30 percent, 50 percent, 70 percent, or 100 percent.

The VA Rating Percentages for PTSD

Following are the VA ratings that you may receive for your current, service-connected PTSD diagnosis: 

• 0 percent – This percent is assigned when a veteran has a diagnosis of PTSD, but it does not impact work or social life and does not require ongoing medication 
• 10 percent – There is a mild impact on social interactions and work efficiency, but it can be controlled with ongoing medication
• 30 percent – Veterans at 30 percent have occasional drops in work efficiency due to difficulties with concentration and can have periodic problems in social relationships 
• 50 percent – At this PTSD VA rating, the veteran experiences social and occupational difficulties that can limit their ability to work and engage in social life
• 70 percent – At this level, the veteran experiences impairment both in social environments and at work and can have problems with independent function and maintaining relationships 
• 100 percent – This is when the veteran has complete occupational and social impairment due to their PTSD symptoms, meaning they are unable to socially function without assistance and cannot work

In order to collect the VA disability benefits you are entitled to, you will need an accurate PTSD VA rating, but first, you have to navigate the filing process and have your claim approved. 

Filing a PTSD Claim 

The VA explains that before filing your application, you need to prepare by first determining your eligibility then gathering the evidence needed to support your totally filled-out claim. To be eligible in basic terms, you must have an “other than dishonorable discharge” status (meaning, an “other than honorable discharge” is disqualifying for VA benefits unless certain exceptions are met), and a current diagnosis of a condition or disability, and that condition or disability must be connected to your qualifying active service in the U.S. Armed Forces. 

The Required Forms

Following are some of the forms you’ll need to file in support of your VA disability claim for PTSD:

• VA Form 21-526EZ – This is the initial form to get started with to apply for your VA disability compensation and other benefits
• VA Form 21-0781 – This form, Statement in Support of Claim for Service Connection for PTSD, is how you can submit supporting evidence concerning your PTSD diagnosis and its service connection
• VA Form 21-8940 – If your PTSD VA rating is 70 percent or higher, or you have a rating higher than 70 percent because of two combined conditions with one at a minimum of 40 percent, you may qualify through this Veteran’s Application for Increased Compensation Based on Unemployability, which awards you 100 percent disability compensation benefits

Supporting Evidence Needed for Your PTSD Claim 

Your C&P exam will be central to your VA disability claim, and you are also able to provide third-party medical opinions, buddy statements, and other evidence in support of your claim. Evidence you can submit to the VA in support of your claim includes:

• Your VA medical records and hospital records 
• Your private, third-party medical records and hospital reports 
• Supporting statements from persons you served with, family, friends, clergy members, and others whose statements can help the VA better understand your claimed condition, how it occurred, and how it may have worsened 

You are able to gather evidence on your own or with the help of your VA disability benefits lawyer, and the VA will also provide limited help to collect evidence. 

Nexus Letters and Medical Evidence

You’ll need to prove that your condition was linked to your qualifying service or was worsened by your service. To do so, a nexus letter can strongly support your PTSD VA rating and the level of benefits you are ultimately approved for. A nexus letter is a medical opinion that, after having conducted a current diagnosis and a review of your prior medical history and the traumatic experience, determines that there is a connection between your current condition and your active service. 

Secondary Service Connection for PTSD 

When your condition was a result of another condition that has already been service-connected, it is considered a secondary service condition by the VA. PTSD is often linked to depression, general anxiety disorder, head injuries, and others. 

Appeals for PTSD Rating

If your PTSD VA disability claim has been denied, you and your family will be unable to collect tax-free disability payments to cover lost earnings from your condition, and medical and mental health services for your PTSD may also go uncovered. When your claim is denied, a successful appeal is essential to get you back on track and able to collect the benefits you deserve. If your appeal is approved, you’ll often be able to collect the benefits you did not receive from the time of your initial application. 

The VA disability lawyers from our VA benefits law firm are standing by to support the success of your appeal, and we only get paid if we win. 

Options to Appeal Your Denied PTSD Claim 

If your PTSD claim has been denied, your options are largely within the scope of VA decision reviews and appeals. You’ll have the options of:

• Decision review – You may file a supplemental claim with new and relevant evidence or ask for a higher-level review, which allows no new evidence.
• Board appeal – Through this option, you are appealing to a Veterans Law Judge at the Board of Veterans’ Appeals, which is located in Washington, D.C.  Through this process a judge with expertise in veterans law reviews your case. 

Deadlines Matter

You have one year following the date of your decision letter to request a Board Appeal, a higher-level review appeal, or a supplemental claim. Although in some situations like simultaneously contest claims (such as attorney fee disputes), the deadline can differ. A supplemental claim can be filed when you have new and relevant evidence, but if it is filed more than one year after the date of the initial denial, the effective date will be the date VA receives the supplemental claim. 

To receive the original claim filing date as your effective date, you must file a supplemental claim within one year of the denial.  Similarly, if you have an older legacy case (i.e. prior to February 19, 2019) that results in a Board denial, you must file an appeal to the U.S. Court of Appeals within 120 days in order to preserve your original filing date.  If you file a supplemental claim after a Board denial of a legacy claim, you risk severing your original effective date.  Great caution should be taken when you receive a Board denial of an older, legacy case.  It is critical to consult with an experienced VA appeals lawyer in those situations within the 120 days following the denial. 

The Benefits of Working with a Veterans Disability Lawyer with a PTSD Focus 

The VA is looking for particular evidence and information throughout your PTSD evaluation process. However, while you may in fact have PTSD, if the evidence submitted to the VA does not demonstrate your condition in a way that the VA can accept, then your claim will be denied. Whether your condition was misdiagnosed during your C&P exam, or the examiner was simply overworked and didn’t give your claim the attention it deserved, a denial can be financially ruinous to you and your household. 

The experienced veterans’ disability lawyers from our VA benefits law firm have decades of combined experience successfully challenging VA claims denials. We have worked on a great many cases dealing specifically with PTSD and recognize the importance of ensuring that your diagnosis and supporting evidence overcomes any defense on behalf of the VA that your condition is simply “malingering” and not PTSD. 

The VA defines “malingering” as “the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives such as avoiding military duty, avoiding work, obtaining financial compensation, etc.”. If the VA determines that your condition is not PTSD but “malingering,” it will be denied. This is why we counsel our clients to be comprehensive but truthful in their C&P exams.  Exaggerating symptoms, more often than not, has a negative impact.  

Connect with a VA Disability Lawyer for Help with Your PTSD Claim

Gathering information and supporting an accurate PTSD VA rating is central to your VA disability benefits claim. To learn how we can help, call toll-free at 888-915-3843 or get in touch to schedule a free case evaluation.

FAQ

What is the average VA rating for PTSD?

While each individual veteran’s situation is reviewed independently, a PTSD VA rating of 70 percent is most common. At this level, the veteran’s symptoms substantially impact their ability to socially function and work, and can qualify them for total disability for individual unemployability or TDIU compensation, which is compensation at the 100 percent disability rate–so long as the condition prevents gainful employment.  If a veteran has less than a 70 percent rating and has major deficiencies in most areas of his life, then he needs to consider filing for an increased rating. 

Is PTSD an automatic 50 percent? 

Your PTSD VA rating is not an automatic 50 percent but will be assigned a percentage of either 0, 10, 30, 50, 70, or 100, depending upon the evidence you provide with your application. 

Is 70 percent PTSD a permanent VA disability? 

PTSD is considered a permanent VA disability, and your PTSD VA rating will determine what percentage you are assigned and what VA disability benefits you are then entitled to. 

What qualifies as PTSD for VA disability? 

You’ll need to file the appropriate forms, including a current medical diagnosis of PTSD from a medical expert, in addition to medical evidence and an opinion linking your PTSD to your qualifying active service in the U.S. Armed Forces.

Tips for a Successful PTSD VA Rating

PTSD can impact the life of a veteran and their family in a broad range of ways, particularly when it impacts the veteran’s ability to socially function and work to support themselves and their family. To collect VA disability benefits for your PTSD, you’ll need to apply and be approved, and the amount of coverage that you are entitled to will depend upon your PTSD VA rating.

Your PTSD is rated on a percentage scale that increases with the severity of your symptoms, and beginning at 10 percent disability entitles you to tax-free monthly disability compensation payments. The VA disability lawyers from our VA disability law firm can help you understand the process and what the VA is looking for to accurately rate your PTSD. 

#1 Submit Sufficient Medical Evidence 

The most important pieces of information to submit with your VA disability claim are a current diagnosis of your condition and a medical opinion linking that condition to an event, injury, or illness that you experienced during active duty. Your current diagnosis is best complemented by a nexus letter, which is a medical opinion that links your current condition with your active duty. 

One of the most common reasons for denial is insufficient evidence of a link between your PTSD and an event, injury, or illness experienced during active duty. The second is insufficient proof that you experience sufficient symptom impairment.  (In service connection claims, the second biggest reason for denial is the inability to corroborate a PTSD stressor during service.)

#2 Keep a Journal Documenting Your Symptoms and Experiences with PTSD

When you suffer from PTSD, the symptoms can impact your ability to live your day-to-day life and also to work. For the VA to understand how your symptoms impact your life, you need to provide them with this information. Documenting your PTSD symptoms in a journal can provide the VA with an important piece of information in support of your claim, as your personal experience best describes how your PTSD affects your life. 

#3 Submit Buddy Statements to Support the Service Connection

With PTSD, which is generally caused by encountering, witnessing, or knowing that a close friend or family encountered, a life-threatening situation of violence, sexual violence, or other experience, the cause is often an experience that the VA will never have an opportunity to witness. You are able to submit a “buddy statement” through VA Form 21-4138, a Statement in Support of Claim. This is how you can submit the witness statement of a person with firsthand knowledge of your condition or what caused it that you believe will support your application for VA disability benefits. 

Keep in mind that the main reasons for adverse outcomes in PTSD cases depends on whether the issue on appeal is a denial of service connection or an appeal for the denial of an increased rating claim.  In cases where service connection is the issue, the focus has to be on establishing the diagnosis, the in-service event (stressor corroboration, combat experience, or presence in a combat theater where there was fear of an hostile attack), and the linkage with service.  In increased rating cases, the focus has to be on documenting the true nature and severity of the symptoms.